Overview:

According to the ICD-10 (F06.1) disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. The extremes of psychomotor disturbance may alternate. [2] The presence of other catatonic symptoms and signs increases the conﬁdence in the diagnosis. [1]

Sign & Symptoms:

2.Rigidity: Maintenance of a rigid posture against efforts to be moved.

3.Negativism: An apparently motiveless resistance to all commands and attempts to be moved, or doing just the opposite.

4.Posturing: Voluntary assumption of an inappropriate and often bizarre posture for long periods of time.

5. Stupor: Akinesis (no movement) with mutism but with evidence of relative preservation of conscious awareness.

6. Echolalia: Repetition, echo or mimic king of phrases or words heard.

7. Echopraxia: Repetition, echo or mimic king of actions observed.

8. Waxy ﬂexibility: Parts of body can be placed in positions that will be maintained for long periods of time, even if very uncomfortable; ﬂexible like wax.

9. Ambitendency: Due to ambivalence, conﬂicting impulses and tentative actions are made, but no goal directed action occurs, e.g. on asking to take out tongue, tongue is slightly protruded but taken back again10. Other signs: Such as mannerisms, stereotypies (verbal and behavioural), automatic obedience (commands are followed automatically, irrespective of their nature) and verbigeration (incomprehensible speech). [1]

4. Psychiatric Disorders:

Diagnosis:

According to the ICD-10(F06.1), the following features are required for the diagnosis of organic catatonic disorder, in addition to the general guidelines for the diagnosis of other organic mental disorders, described earlier:

Treatment:

1. Treatment of the underlying cause, if amenable to treatment.

2. Symptomatic treatment with low dose of a short acting benzodiazepine (e.g. Lorazepam), or electroconvulsive therapy (if needed). Antipsychotics should usually be avoided as they can make catatonic features worse; however small doses of atypical antipsychotics such as Risperidone, Olanzapine, Aripiprazole or Quetiapine can be used with care. [1]